What are some of the reasons for young people in Kenya to have abortions? What issues do they encounter if they choose to terminate a pregnancy? Finding answers to these questions can ultimately save lives. She Makes Her Safe Choice, our unintended pregnancies and safe and legal abortions program, is currently conducting qualitative research into the ‘lived experiences’ of girls and young women who experience unintended pregnancies and do (or don’t) have abortions in Kenya’s coastal region.
Nothing about us, without us. This is a guiding principle for all our work improving the sexual and reproductive health of young people. From research design to the dissemination stage, Rutgers and its partner, the African Population and Health Research Center, have involved young people. Not just because it’s important young people represent their own experiences, it can also result in more reliable insights. Especially when working on topics that can be sensitive. For junior researchers Jane, Kadzo, Sheila and Anne, this project is so vital because “you get to see what’s really happening on the ground.”
Why involve young people as researchers?
“I think involving young researchers is very important, because our study-participants are still girls”, explains Jane. According to her, young researchers and study participants “can easily relate to each other because we’re the same age. They can easily open up to a young researcher. A young girl told me she didn’t know the name of the man who had impregnated her. Because we are the same age, it’s easier for the participants to open up and we can relate.”
Anne: “It’s really important for young people to participate in the research. The people who are affected are young and are facing the same issues as us. We are transitioning from having parental support to supporting ourselves in life. I identify with their situation. Without young researchers the outcomes would be different. From what I’ve seen, the participants don’t talk much to their caregivers. They try to filter some things out because they know it’s wrong in society. If someone is your mother’s age, and you can’t even tell your mother, then you can’t open up. Since we are like a friend or a sister, they can open up.”
“Opening up to an older person is hard for young people,” says Sheila. “They feel like they might get judged. Opening up to me, is like opening up to a peer or a sister. They feel more safe”. And the learning doesn’t just go one way: “One thing that is so unique and engaging with the study methodology is that you learn a lot from the girls. What I didn’t know, was the abortion aspect of their lives. This county has a high rate of teenage pregnancy. To my shock, most of those pregnancies don’t come to term. That surprised me. I didn’t know we had so many cases.”
The same goes for Kadzo: “I had never talked to teenagers who’ve had abortions before. It’s been a real learning experience. Even young girls have abortions. I used to think it was just grown-ups who have abortions. It’s an emotional experience for the girls and they need someone to talk to. They are often alone. I’ve come to learn that these young girls go through very hectic situations.”
What are the ins and outs of research into young people’s experiences by young people? And how do the junior researchers go about their work?
Jane explains: “We are conducting ethnographic studies to find out more about the lived experiences of young women and girls who have undergone an abortion. We follow up with the study participants, learn more about their lives and especially how their lives have been affected by undergoing an abortion. It involves interviewing and observation, from the moment they enter the facility until they leave. It can be a bit challenging to find participants who are willing to participate in the study, not because there are no abortions, but because of the stigma.”
“I really like this research method,” says Kadzo. “You get to know someone really well. It’s better than just an interview. This way, you talk to them several times a week and it gets to a point where they open up. You get to learn what is really happening on the ground. If it was older people doing this research, the girls might feel intimidated, just like talking to your parents about such sensitive issues.”
For Sheila a typical day includes a visit to her assigned clinic, the identification of a respondent and then an extensive period of observation. “In the community, I follow respondents. If I meet girls, I go to their homes, their workplaces, et cetera. We chat to get to know them well, so I can get their insights on the study subject. I was used to working with questionnaires, but I had not done ethnography before. The emotions are also very interesting. You get to learn other things that you wouldn’t know if you only observed the respondents once.”
What do the junior researchers expect to find?
“One of our expected outcomes is the need for skilled post-abortion care providers,” says Jane. “There is a need for investing more in this kind of care. Poverty plays a big role in decision making around abortion. In the rural parts of Kilifi county, you find families where the situation is very desperate and the living standards are low. Large families live in single-roomed houses. They don’t have money to purchase sanitary products, so they have sex in exchange for sanitary towels or food. The main economic activity is agriculture, but the land doesn’t produce much because it’s dry.”
Anne also adds an extra finding that struck her: “In terms of sexual and reproductive health and rights, and abortion, I can say girls have a lot of information. It’s only that the culture is highly patriarchal. The women know what to do but they will still ask the men in their lives for approval/ permission yet those men don’t always understand the situation. They make decisions without knowledge, negatively affecting the lives of the women. Before this research, I didn’t know how patriarchy affects the reproductive health of women.”
What’s next for the young researchers?
Participating in this study as junior researchers has given them more than just insights into the issue. It’s deepened their understanding of sexual and reproductive health and rights, as well as boosted their own careers. Kadzo: “I’ve realised girls are procuring abortions, but hiding it. Most of the time it’s unsafe, it affects their health, as well as the health of the community. More information is needed for the community on how to prevent unsafe abortions. I myself want to continue working with the teenagers on different projects and know their experiences and help them. Not just as a mentor, but as a researcher, I want to come up with projects that can help them.”
Jane also wants to stay involved in similar projects on reproductive health: “I feel like I need to do more research, before I can become a policymaker. Right now, policymakers don’t always make plans from a point of knowledge, and sometimes they get it wrong. So I would like to do research projects in different capacities, before I can progress to becoming a policymaker.”
“I hope our insights contribute to better information for girls and young women”, says Sheila. “We don’t have to pretend abortion isn’t happening. If we give young people the right information, we can save a generation.”
Anne: “I would like to continue as a researcher. I want to build my research skills and competence. Not just in Kenya but across Africa. I’ve seen the need. There is a need for more research and information, and also more impact.”
This blog was based on an interview with APHRC-based researchers: Anne Achieng’, Kadzo Mwadhi, Sheila Unda and Jane Shirima.
Find it here on the Rutgers website.